A goodbye to my doctor of nearly three decades

COMMENTARY

WILLIAMSTOWN - "If you like your doctor, you can keep your doctor," President Barack Obama said back in 2009 when discussing the Affordable Care Act, which included provisions designed to make health coverage affordable to Americans who struggled to pay for their coverage. In the state of Massachusetts, residents over 18 who can afford health insurance must have it for the entire year or pay a penalty through their tax returns, due to the Massachusetts Health Care Reform Law. Everyone in our commonwealth must have health insurance, and the state offers affordable plans through the Connector.

For most Americans, health insurance is provided by their employer. And over the last couple of decades, many of us have seen premiums go up as fewer services are covered. In my opinion, health management organizations are no longer "insurance." Auto insurance will still cover you in an accident, based on your deductible. With health insurance, if you are injured, need emergency care or get really sick, expect to pay out of pocket in most circumstances. Only in America do you have to have a spaghetti supper or other fundraiser to pay for cancer treatments or other catastrophic illness. I have even received mail offers for supplemental "cancer insurance." Doesn't that say it all?

On the day I completed my open enrollment back in November of last year, I received a letter from my primary care physician stating that he was no longer accepting my insurance carrier. The letter went on to indicate which insurance carriers the office was accepting and that since it was an open enrollment period I could perhaps change my insurance carrier so that I could continue to be a patient.

That was not an option for me since my primary employer provides my health coverage and undoubtedly must work tirelessly to find a provider for their employees. Over the last three decades, I've had a few different providers from Blue Cross and Blue Shield to Tufts.

Ultimately, I wasn't surprised to learn that my doctor was no longer taking my insurance. I figured that, among other things, the reimbursement rate to the physician probably wasn't that great. I had been told by one of my specialty doctors that he was going to have to raise his co-pay or fee because he was unable to get any reimbursement from many insurance companies, including mine. When I went into my primary care physician's office to pay my latest bill, I got an explanation as to why they no longer took my insurance.

"Haven't seen you in a while, Gillian," the receptionist said as I gave her my credit card for payment.

"I'm afraid this will likely be the last time you see me since your office is no longer taking my insurance," I said sadly.

As a journalist, I asked for an honest assessment of why they were no longer accepting my insurance carrier.

She said that, overall, they were impossible to work with. From a low reimbursement rate to availability, I believe they had simply had enough of dealing with them.

I thanked her for the many years of checking me in to my appointments, and she even gave me paperwork so that the transfer of my health records could be facilitated. While this change is certainly an inconvenience, I'm not angry at my doctor, only peeved by the insurance company. I believe this is a systemic problem.

My doctor was not only my PCP but my late mother's as well. There is so much history there and the staff in the office knows me well. It is sad to feel like I am losing not only my doctor but a group of people who were like family to me, especially during the time that I was a caregiver to my mother.

I am no stranger to change, especially with my physicians. As a young woman, I went to the same gynecologist's office for decades. I had to transfer to another practice just before the pandemic as one by one the doctor's in the office retired and the practice closed. Living in the Berkshires, I have been fortunate to have some really good doctors. But I also know that doctors who decide to practice here make a sacrifice to do so. While the Berkshires are a beautiful place to live and raise children, doctors do not make the same salary as they would in a metropolitan area, and with the student debt that most physicians carry it is a real problem.

I've spent a lot of time in various doctors' offices in the Berkshires, especially with my late mom, and I appreciate the strain that many physicians are under. Many of those who are of an age to retire are unable to do so in good conscience, and many came out of retirement during the pandemic. I witnessed many helping out with COVID vaccination clinics. Being a doctor is a calling and a noble profession. Since the pandemic, those in the health care field have been undervalued and under-appreciated for their services. Some have left the profession altogether.

Since I first began writing this column, I met with my new practitioner and I had a wonderful experience at Community Health Programs in North Adams.

While I will miss my doctor of the last 30 years, I am glad that my former physician is standing up against the health insurance companies by deciding to no longer take insurance that does not value the physician or the patient. It is a small step, but perhaps if more people take a stand, positive change can be made.

Gillian Jones, an Eagle visual journalist, writes a monthly op-ed series. Her email is [email protected].

My doctor was not only my PCP but my late mother's as well. There is so much history there and the staff in the office knows me well. It is sad to feel like I am losing not only my doctor but a group of people who were like family to me, especially during the time that I was a caregiver to my mother.